This project will develop a plan for the implementation of an ambulatory EMR in a medically underserved region of east central Illinois. Sarah Bush Lincoln Health Center (SBLHC), a not-for-profit community healthcare corporation, will serve as the fiscal agent and work in partnership with three independent physician practices to develop an ambulatory EMR which 1) provides shared access to patient records across hospital services, home health, hospice, physician practice settings; and 2) improves patient safety. [unreadable] [unreadable] Project partners include K.A. Fehrenbacher, M.D., Ltd. (family practice); Urology Associates (urology practice of Roger Rives, M.D., and David D. DiDomenico, M.D., D.O.); and Zaveri and Associates, S.C. (cardiology practice of Shailesh Zaveri, M.D. and B.S. Lakshiminarayanan, M.D.). The partners of this project envision an EMR that will electronically connect physician offices, the SBLHC regional hospital and its ancillary services, and other community health services. We intend to identify processes and resources needed to share a longitudinal medical record that contains, at a minimum, a patient problem list, medication list, allergies, radiology, images and data, laboratory data, and a patient care plan. The project will identify indicators to track measurable improvements in patient safety and quality of care, clinician and patient satisfaction, and operational efficiencies. The long-term goals of the partnership are as follows: 1) Successfully deploy an ambulatory EMR with shared access to patient records across hospital services, home health, hospice, and employed and independent physician practice settings; 2) use computerized physician order entry and clinical decision support systems to reduce medication errors and increase patient safety; and 3) provide a method to utilize the EMR for data collection, analysis, and reporting of the number and types of medication errors and adverse events identified and prevented, as well as the number and types of actual errors and adverse events which occur. [unreadable] [unreadable] [unreadable]